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Proposals to promote health and prevent voice disorders in occupational voice users: A scoping review
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Martins, Glauciene Amaral

; Saito, Isabele Tiemi

; Viegas, Flávia

; Simões-Zenari, Marcia

; Nemr, Katia

Revista CEFAC

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2024, Volume 26 N. 1 elocation e11022

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Purpose: to characterize the actions of vocal health promotion and/or prevention of vocal disorders applied to voice professionals. Methods: a scoping review following the PRISMA-ScR guidelines in SciELO and PubMed databases was conducted. Articles that had as participants voice professionals without concomitant vocal treatment, that described proposals for health promotion or vocal disorders prevention, published between 2010 and 2023, were included. They were grouped into categories and data were presented descriptively. Literature Review: eighteen articles with artistic and non-artistic voice professionals, mostly teachers, were included. Most of the studies focused on healthy voices, aiming at primary prevention. Many articles presented guidance on vocal hygiene and health and used resources such as vocal enhancement, voice workshop, voice amplifiers and apps. All the articles positively mentioned their results, especially with regard to self-perception in relation to voice, vocal quality and quality of life, awareness of positive and harmful practices to the voice. Conclusion: the proposals contemplated different levels of prevention, but most focused on primary prevention, including vocally healthy participants; all articles indicated positive results in voice self-perception, voice quality and quality of life, and awareness of positive and harmful voice practices.

RESUMO Objetivo: caracterizar as ações de promoção de saúde vocal e/ou prevenção de distúrbios vocais aplicadas em profissionais da voz. Métodos: foi conduzida uma revisão de escopo seguindo as diretrizes do PRISMA-ScR nas bases de dados SciELO e PubMed. Foram incluídos artigos que tivessem como participantes profissionais da voz sem tratamento vocal concomitante, que descrevessem propostas de promoção da saúde ou prevenção de distúrbios vocais, publicados entre 2010 e 2023. Os artigos foram agrupados em categorias e os dados apresentados de forma descritiva. Revisão da Literatura: foram incluídos 18 artigos com profissionais da voz artística e não-artística, em sua maioria professores. A maior parte dos estudos tinha como foco vozes saudáveis, visando a prevenção primária. Muitos artigos apresentaram orientações sobre higiene e saúde vocal e utilizaram recursos como aprimoramento vocal, oficina de voz, amplificadores de voz e aplicativos. Todos os artigos mencionam resultados benéficos, principalmente no que se refere à autopercepção em relação a voz, qualidade vocal e de vida, conscientização de práticas positivas e prejudiciais à voz. Conclusão: as propostas contemplaram diferentes níveis de prevenção, mas a maioria tinha como foco a prevenção primária, incluindo participantes vocalmente saudáveis; todos os artigos indicaram resultados favoráveis na autopercepção em relação à voz, qualidade vocal e de vida e conscientização de práticas benéficas e prejudiciais à voz.

https://doi.org/10.1590/1982-0216/202426111022

Acoustic Measurements of Speech and Voice in Men with Angle Class II, Division 1, Malocclusion
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Viegas, Flávia

; Camargo, Zuleica

; Viegas, Danieli

; Guimarães, Glaucio Serra

; Luiz, Ronir Raggio

; Ritto, Fabio

; Simões-Zenari, Marcia

; Nemr, Katia

International Archives of Otorhinolaryngology

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mar 2023, Volume 27 N. 1 Pages 10 - 15

Abstract: En | Text: En | PDF: En

Abstract Introduction The acoustic analysis of speech (measurements of the fundamental frequency and formant frequencies) of different vowels produced by speakers with the Angle class II, division 1, malocclusion can provide information about the relationship between articulatory and phonatory mechanisms in this type of maxillomandibular disproportion. Objectives To investigate acoustic measurements related to the fundamental frequency (F0) and formant frequencies (F1 and F2) of the oral vowels of Brazilian Portuguese (BP) produced by male speakers with Angle class II, division 1, malocclusion (study group) and compare with men with Angle class I malocclusion (control group). Methods In total, 60 men (20 with class II, 40 with class I) aged between 18 and 40 years were included in the study. Measurements of F0, F1 and F2 of the seven oral vowels of BP were estimated from the audio samples containing repetitions of carrier sentences. The statistical analysis was performed using the Student t-test and the effect size was calculated. Results Significant differences (p-values) were detected for F0 values in five vowels ([e], [i], [o], [o] and [u]), and for F1 in vowels [a] and [ɔ], with high levels for class II, division 1. Conclusion Statistical differences were found in the F0 measurements with higher values in five of the seven vowels analysed in subjects with Angle class II, division 1. The formant frequencies showed differences only in F1 in two vowels with higher values in the study group. The data suggest that data on voice and speech production must be included in the protocol’s assessment of patients with malocclusion.

https://doi.org/10.1055/s-0041-1730428

Risco de disfonia e qualidade vocal em estudantes de artes cênicas
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Ferrari, Eloisa Pinheiro

; Simões-Zenari, Marcia

; Master, Suely

; Nemr, Katia

CoDAS

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2023, Volume 35 N. 4 elocation e20220036

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Purpose To analyse the relationship between the risk of dysphonia and vocal quality in undergraduate performing arts students. Methods Observational cross-sectional study with 38 undergraduate students in Performing Arts. We applied screening protocols for general and specific risk of dysphonia for actors and made recordings of sustained emission of the vowel /a/, spontaneous speech and reading a text, used for perceptual analysis performed by three evaluators using the GRBASI scale. After intra and inter-rater reliability tests it was obtained final classification of the general degree of vocal deviation parameter for each participant. Comparisons were made considering groups that had or did not have other profession/activity with the use of voice, and the groups were formed from the general grade. Results Most students were at high risk for dysphonia. All had vocal alteration, with a predominance of mild degree. Students who had another profession/activity with voice use scored higher in the specific protocol for actors, and in the sum of this protocol with the general screening protocol. There was no relationship between the degree of vocal alteration and the risk of dysphonia. Students who did not yet work professionally had more moderate or severe vocal alterations, and those who did work professionally had a higher frequency of mild vocal alterations. Conclusion Most students were at high risk for dysphonia. All had vocal alteration, with a predominance of mild alteration. There was no relationship between the risk of dysphonia and the degree of vocal alteration.

RESUMO Objetivo Analisar a relação entre o risco de disfonia e a qualidade vocal em estudantes de graduação em Artes Cênicas. Método Estudo transversal observacional com 38 estudantes de graduação em Artes Cênicas. Foram aplicados protocolos de rastreio de risco de disfonia geral e específico para atores, e realizadas gravações da emissão sustentada da vogal /a/, fala espontânea e leitura de texto, usadas para análise perceptivo-auditiva, efetuada por três avaliadores, com o uso da escala GRBASI. Após testes de confiabilidade intra e interavaliadores chegou-se à classificação final do grau geral do desvio vocal para cada participante. Foram feitas comparações entre grupos que tinham ou não outra profissão/atividade com o uso da voz e os grupos formados a partir do grau geral. Resultados A maioria dos estudantes apresentou alto risco para disfonia. Todos apresentaram alteração vocal, com predominância de grau leve. Os estudantes que tinham outra profissão/atividade com uso da voz obtiveram maior pontuação no protocolo específico para atores, bem como na soma desse protocolo com o de rastreio geral. Não houve relação entre o grau de alteração vocal e o risco de disfonia. Os estudantes que ainda não atuavam profissionalmente apresentaram mais alterações vocais de grau moderado ou severo, e os que atuavam profissionalmente apresentaram com maior frequência alteração vocal de grau leve. Conclusão A maior parte dos estudantes apresentou alto risco para disfonia. Todos apresentaram alteração vocal, com predomínio de grau leve. Não houve relação entre o risco de disfonia e o grau de alteração vocal.

https://doi.org/10.1590/2317-1782/20232022036pt

Reduzindo o GAP entre a ciência e a clínica: lições da academia e da prática profissional – parte A: julgamento perceptivo-auditivo da qualidade vocal, análise acústica do sinal vocal e autoavaliação em voz
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Behlau, Mara

; Almeida, Anna Alice

; Amorim, Geová

; Balata, Patrícia

; Bastos, Sávio

; Cassol, Mauricéia

; Constantini, Ana Carolina

; Eckley, Claudia

; Englert, Marina

; Gama, Ana Cristina Cortes

; Gielow, Ingrid

; Guimarães, Bruno

; Lima, Livia Ribeiro

; Lopes, Leonardo

; Madazio, Glaucya

; Moreti, Felipe

; Mouffron, Vanessa

; Nemr, Katia

; Oliveira, Priscila

; Padovani, Marina

; Ribeiro, Vanessa Veis

; Silverio, Kelly

; Vaiano, Thays

; Yamasaki, Rosiane

CoDAS

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2022, Volume 34 N. 5 elocation e20210240

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO No XXVIII Congresso Brasileiro da SBFa, 24 especialistas reuniram-se e, a partir de um posicionamento condutor sobre pesquisa científica como ferramenta de conexão entre laboratório e clínica, cinco frentes de conhecimento da especialidade de voz foram discutidas: 1. Julgamento perceptivo-auditivo da qualidade vocal; 2. Análise acústica do sinal vocal; 3. Autoavaliação em voz; 4. Técnicas tradicionais de terapia; 5. Técnicas modernas de eletroestimulação e fotobiomodulação em voz. A parte “a” desta publicação é a consolidação das análises dos três primeiros aspectos. A tendência no julgamento perceptivo-auditivo da qualidade vocal é o uso de protocolos padrão. A avaliação acústica do sinal vocal é acessível e pode ser feita de modo descritivo ou por extração de parâmetros, preferindo-se medidas multiparamétricas. Finalmente, a análise do próprio indivíduo fecha essa tríade de documentação fonoaudiológica, que será base para a conclusão da avaliação, referência para monitoramento do progresso e avaliação de resultado de tratamento.

ABSTRACT During the XXVIII Brazilian Congress of SBFa, 24 specialists met and, from a leading position on scientific research as a tool for connecting laboratory and clinic, five fronts of knowledge of the voice specialty were discussed as following: Perceptual-auditory judgment of vocal quality; 2. Acoustic analysis of the vocal signal; 3. Voice self-assessment; 4. Traditional techniques of therapy; 5. Modern techniques of electrostimulation and photobiomodulation (PBMT) in voice. Part “a” of this publication was associated with the consolidation of the analyses of the first three aspects. The trend in the perceptual-auditory judgment of vocal quality was related to the use of standard protocols. The acoustic evaluation of the vocal signal is accessible and can be done descriptively or by extraction of parameters, thus preferring multiparametric measures. Finally, the analysis of the individual himself closes this triad of voice documentation, which will be the basis for the conclusion of the evaluation, reference for monitoring progress, and evaluation of treatment results.

https://doi.org/10.1590/2317-1782/20212021240pt

Reduzindo o gap entre a ciência e a clínica: lições da academia e da prática profissional – parte B: técnicas tradicionais de terapia vocal e técnicas modernas de eletroestimulação e fotobiomodulação aplicadas à reabilitação vocal
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Behlau, Mara

; Almeida, Anna Alice

; Amorim, Geová

; Balata, Patrícia

; Bastos, Sávio

; Cassol, Mauriceia

; Constantini, Ana Carolina

; Eckley, Claudia

; Englert, Marina

; Gama, Ana Cristina Cortes

; Gielow, Ingrid

; Guimarães, Bruno

; Lima, Livia Ribeiro

; Lopes, Leonardo

; Madazio, Glaucya

; Moreti, Felipe

; Mouffron, Vanessa

; Nemr, Katia

; Oliveira, Priscila

; Padovani, Marina

; Ribeiro, Vanessa Veis

; Silverio, Kelly

; Vaiano, Thays

; Yamasaki, Rosiane

CoDAS

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2022, Volume 34 N. 5 elocation e20210241

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO O presente texto é a continuação da publicação referente ao XVIII Congresso da SBFa. Na parte “A” apresentamos análises sobre avaliação clínica vocal. O foco da parte “B” são aspectos de reabilitação vocal: 4. Técnicas tradicionais de terapia vocal; 5. Técnicas modernas de eletroestimulação e fotobiomodulação aplicadas à reabilitação. Os inúmeros estudos sobre os diversos programas, métodos ou técnicas tradicionais de reabilitação, muitos de elevada qualidade de evidência, permitem considerar tais procedimentos relativamente bem descritos, seguros e com efeitos conhecidos, dando conta do tratamento de diversos distúrbios vocais. As evidências científicas com as técnicas tradicionais são reconhecidas mundialmente. Novas frentes de evolução, como o uso da eletroestimulação ou fotobiomodulação em voz parecem ser promissoras como abordagens coadjuvantes. Há mais estudos sobre eletroestimulação em voz do que com fotobiomodulação, contudo, evidências científicas para essas duas técnicas modernas são ainda limitadas. Conhecimento e cautela são necessários para a aplicação de quaisquer técnicas.

ABSTRACT This text is the continuation of the XVIII SBFa Congress publication. In part “A” we presented the analyses on clinical vocal evaluation. Part “B” focuses on vocal rehabilitation: 4. Traditional techniques of vocal therapy; 5. Modern techniques of electrostimulation and photobiomodulation applied to vocal rehabilitation. The numerous studies on the various programs, methods, and techniques of traditional rehabilitation techniques, and many with high quality of evidence, allow us to consider such procedures relatively well described, safe, and with known effects, accounting for the treatment of various vocal disorders. The scientific evidence with traditional techniques is recognized worldwide. New fronts of evolution, with electrostimulation or photobiomodulation used to handle voice problems, seem to be promising as coadjutant approaches. There are more studies on electrostimulation in vocal rehabilitation than with photobiomodulation; however, scientific evidence for these two modern techniques is still limited. Knowledge and caution are required for the application of either technique.

https://doi.org/10.1590/2317-1782/20212021241pt

Voz do idoso: o avanço da idade gera diferentes impactos?
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Gomes, Anna Beatriz de Paiva

; Simões-Zenari, Marcia

; Nemr, Kátia

CoDAS

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2021, Volume 33 N. 6 elocation e20200126

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo Verificar se existem diferenças em aspectos vocais entre idosos com presbifonia, divididos em três faixas etárias. Método Participaram 60 idosos de ambos os sexos com idades entre 60 e 90 anos (média=72,3), com diagnóstico de presbifonia estabelecido em avaliação otorrinolaringológica. A partir da gravação das vozes foi realizada análise perceptivo-auditiva e acústica e os dados foram comparados por meio dos testes estatísticos com os participantes divididos nos grupos etários 60-70 anos, 71-80 anos e 81-90 anos. Resultados Ainda que os idosos dos três grupos tenham apresentado alterações em aspectos vocais variados, como instabilidade e ruído em frequências graves, aqueles com mais de 80 anos apresentaram maior grau de disfonia, rugosidade, soprosidade e pitch. Também foram observados neste grupo maiores desvios em jitter, shimmer e irregularidade e a medida GNE no limite da normalidade. Todas as diferenças foram estatisticamente significativas. A maioria dos idosos dessa faixa etária apresentou ainda alteração no diagrama de desvio fonatório e quebra de frequência. Conclusão Diversos aspectos perceptivo-auditivos e acústicos se apresentaram mais desviados nos idosos mais velhos, o que reforça a necessidade de serem consideradas essas especificidades tanto na avaliação dos efeitos do envelhecimento na voz quanto no desenvolvimento de ações para minimizar o declínio vocal.

ABSTRACT Purpose To verify if there are differences in the vocal aspects of older people from three different age groups with presbyphonia diagnosis. Methods Sixty older adults joined this study. They were both female and male, with an age range from 60 to 90 years old (average: 72.3) and with presbyphonia diagnosis established after otolaryngology evaluation. From their voice recordings, it was possible to make the acoustic and auditory-perceptual analysis. The data collected was compared through statistical tests considering the division of the participants into the following groups: 60-70 years old, 71-80 years old, and 81-90 years old. Results Even though the older people from all of the three groups have presented deviation in multiple vocal aspects such as instability and vocal noise in low frequencies, those with more than 80 years old have presented a higher deviation of the general grade of dysphonia, roughness, breathiness, and pitch. In this group, it was also observed higher deviations in jitter, shimmer, vocal breaks, and the GNE measure on the edge of normality. All the differences were statistically significant. The majority of the older participants from that group presented even a deviation in the phonatory deviation diagram and frequency break. Conclusion Various acoustic and auditory-perceptual aspects had a higher deviation in the older adults over 80 years old, which reinforces the need to consider those specificities in the evaluation of the vocal aging impacts and also in the development of actions to minimize vocal declination.

https://doi.org/10.1590/2317-1782/20202020126 100 downloads

COVID-19 and the teacher's voice: self-perception and contributions of speech therapy to voice and communication during the pandemic
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Nemr, Katia

; Simões-Zenari, Marcia

; Almeida, Vanessa Cássia de

; Martins, Glauciene Amaral

; Saito, Isabele Tiemi

Clinics

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2021, Volume 76 elocation e2641

Abstract: En | Text: En | PDF: En

OBJECTIVES: We aimed to analyze the vocal self-perception of Brazilian teachers and their communication needs, vocal signs and symptoms, and voice-related lifestyles during the coronavirus disease (COVID-19) pandemic and, based on this information, to develop guidance materials intended for dissemination to these teachers and the general community. METHODS: An online questionnaire designed for this survey was distributed via the researchers' networks and was available for completion by any teacher, except those who were not working at the time. There were 1,253 teachers from all over Brazil, of both sexes, covering a wide age range, working at different levels of education, and most with more than ten years of experience. Descriptive and inferential analyses of the data were performed. RESULTS: On comparing the prepandemic period with the current one, participants indicated voice improvements. In contrast, they presented symptoms such as dry throat, effort in addressing remote classes, hoarseness after classes, and difficulties with the use of headphones, among others. They further indicated stress, general fatigue, impact of the pandemic on mental health, and the overlapping of many home tasks with professional tasks. Some smoked, and others hydrated insufficiently. CONCLUSION: Although teachers generally noticed voice improvements during the pandemic, a proportion of them perceived worsening of voices. Many indicated several factors in which speech-language pathologists could guide them with the aim of improving performance and comfort during remote and hybrid classes, an initiative that will positively impact not only their voice and communication but also their quality of life.

https://doi.org/10.6061/clinics/2021/e2641 1214 downloads

Eletroestimulação funcional associada à fonação em mulheres sem alterações vocais
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Romansina, Dinete

; Simões-Zenari, Marcia

; Nemr, Kátia

CoDAS

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2021, Volume 33 N. 1 elocation e20190190

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo Verificar o efeito imediato da corrente elétrica excitomotora, denominada FES, na qualidade vocal e no tempo máximo de fonação (TMF), e possíveis desconfortos, em mulheres sem alteração vocal, com aplicação em intensidade máxima suportada (IMS) e associada à fonação. Método Estudo experimental com 20 mulheres adultas normofônicas. Elas emitiram a vogal /a/ sustentada e depois foi aplicada a FES durante emissão da mesma vogal. Foram cinco séries com três minutos de emissão cada, intercaladas com descanso passivo; o estímulo elétrico foi na IMS pela participante, ajustado por série. Antes e após as emissões as vozes foram gravadas e coletados os TMF e a intensidade dos estímulos. A qualidade vocal foi classificada por juízes. Foram comparados os dados pré e pós emissão/eletroestimulação em cada fase. A análise qualitativa foi realizada a partir de sintomas autorreferidos. Resultados Não houve diferença na qualidade vocal e nos TMF entre os momentos pré e pós nas duas fases. A diferença entre a IMS e a intensidade de percepção do estímulo foi maior na série 1 em relação à série 2. Houve aumento da IMS na série 5 em relação à série 1. Não foram relatados sintomas negativos imediatos ou em até 48 horas após os procedimentos. Conclusão A corrente FES em IMS, associada à fonação, não gerou mudança imediata na qualidade vocal, nos TMF ou desconfortos autorreferidos pelas mulheres sem alteração vocal, mesmo com aumento gradual do estímulo.

ABSTRACT Purpose To verify the immediate effect of the Excitomotor Electrical Current, called Functional Electrical Stimulation (FES), on vocal quality, Maximum Phonation Time (MPT) and possible discomfort, in women without vocal alteration, with application at Maximum Supported Intensity (MSI) and associated with phonation. Methods Experimental study with 20 normophonic adult women. They emitted the sustained vowel / a / and then it was applied to FES during emission of the same vowel. There were five series with three minutes of emission each, interspersed with passive rest. The electrical stimulus was at the MSI by the participant, adjusted by series. Before and after the emissions the voices were recorded and the MPT and the intensity of the stimuli were collected. The vocal quality was rated by judges. Statistical analysis made it possible to compare pre and post emission / electrostimulation data in each phase. Qualitative analysis was performed based on self-reported symptoms. Results There was no difference in vocal quality and MPT between pre and post moments in both phases. The difference between MSI and stimulus perception intensity was greater in series 1 than in series 2. There was an increase in MSI in series 5 compared to series 1. No significant negative symptoms or within 48h after procedures were reported. Conclusion The FES at MSI, associated with phonation, did not generate an immediate change in vocal quality, in the MPT or self-reported discomforts by women without vocal alteration, even with a gradual increase in the stimulus, series by series.

https://doi.org/10.1590/2317-1782/20202019190 394 downloads

Protocolo de Rastreio do Risco de Disfonia para Atores de Teatro Musical: resultados preliminares
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Paulino, Lucas Cainan

; Simões-Zenari, Marcia

; Nemr, Katia

CoDAS

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2021, Volume 33 N. 1 elocation e20190112

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo Propor o Protocolo de Rastreio do Risco de Disfonia para Atores do Teatro Musical (PRRD-TM), verificar sua aplicabilidade em associação ao Protocolo de Rastreio do Risco de Disfonia Geral (PRRD-G), correlacionar escores finais de ambos, e desses com o escore total, e comparar o risco de disfonia entre atores com e sem queixa vocal. Método Estudo transversal observacional com 34 atores de teatro musical adultos, ambos os sexos, com e sem queixa vocal, profissionais ou estudantes. Os questionários foram aplicados individualmente. A análise estatística possibilitou verificar a correlação entre os escores de risco de disfonia e para comparação entre os grupos com e sem queixa vocal. Resultados A maioria dos participantes era do gênero masculino, jovens adultos, atores profissionais e sem queixa vocal. Observou-se elevado risco de disfonia, evidenciado pela aplicação do PRRD-G, com escores médios compatíveis com valores encontrados em indivíduos com disfonia, e reforçado pelos índices encontrados com aplicação do PRRD-TM. Observou-se correlação moderada e diretamente proporcional entre os escores dos dois questionários e desses com o escore total. Escores mais elevados do PRRD-G foram encontrados no grupo que apresentou queixa vocal. Conclusão O PRRD-TM mostrou-se viável e de fácil aplicabilidade e apresentou correlação positiva com o escore do PRRD-G e com o escore total. Elevado risco de disfonia foi evidenciado em indivíduos com queixa vocal. Apesar do escore específico do PRRD-TM não diferenciar atores de teatro musical com e sem queixa vocal, tanto o escore do PRRD-G quanto o escore total realizaram tal diferenciação.

ABSTRACT Purpose To propose the Dysphonia Risk Screening Protocol for Musical Theatre Actors (DRSP-MTA), to verify its applicability in association with the General Dysphonia Risk Screening Protocol (G-DRSP), to correlate the final scores of both, and these with the total risk score, and to compare the risk of dysphonia measured in musical theater actors with and without vocal complaint. Methods An observational cross-sectional study with 34 musical theater actors, adults, of both genders, with and without vocal complaints and regardless of whether they are professionals or students. The questionnaires were applied individually. Statistical analysis made it possible to verify the correlation between the dysphonia risk scores and to compare the groups with and without vocal complaint. Results Most of the participants were male, young adults, professional actors and without vocal complaint. There was a high risk of dysphonia, evidenced by the application of G-DRSP, with means scores compatible with values found in individuals with dysphonia, and reinforced by the indices found with DRSP-MTA application. There was a moderate and directly proportional correlation between the two questionnaire scores; and a correlation of both with the total risk score. Higher G-DRSP scores were observed in the vocal complaint group. Conclusion DRSP-MTA was feasible and easy to apply and was positively correlated with the total score and G-DRSP score. A high risk of dysphonia was evidenced in individuals with vocal complaints. Although the specific DRSP-MTA score did not differentiate musical theatre actors with and without vocal complaints, the G-DRSP score and the total risk score performed such differentiation.

https://doi.org/10.1590/2317-1782/20202019112 314 downloads

10.

Qual o risco de disfonia em trabalhadores que usam a voz em ambiente universitário?
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Silva, Bruna Gabriela Mechi da

; Simões-Zenari, Marcia

; Nemr, Katia

Audiology - Communication Research

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2021, Volume 26 elocation e2429

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo avaliar o risco de disfonia e a presença de alteração vocal em profissionais de diferentes categorias que atuam em ambiente universitário. Métodos pesquisa transversal com uso do Protocolo de Rastreio de Risco de Disfonia para análise das variáveis gênero, idade, hidratação, tabagismo, categoria profissional e demanda vocal e para cálculo do escore final. A gravação da voz ocorreu no ambiente de trabalho, com uso do protocolo Consenso da Avaliação Perceptivo-Auditiva da Voz - CAPE-V. A análise perceptivo-auditiva foi feita por juízes. Os dados foram comparados entre os grupos alto/baixo risco de disfonia e presença/ausência de alteração vocal. Resultados participaram 80 indivíduos, média de idade de 47,7 anos, 84% do gênero feminino. Observou-se alto risco de disfonia em 70% deles e alteração vocal em 34%. Hidratação insuficiente e tabagismo foram frequentes. No grupo com risco elevado de disfonia e presença de alteração vocal destacaram-se os funcionários da área administrativa e, no grupo com menor risco e sem alteração, os funcionários da saúde. Idade mais avançada foi associada à presença de alteração vocal, independentemente dos grupos. Conclusão a identificação do alto risco de disfonia e a relevante presença de alterações vocais em indivíduos de diferentes categorias profissionais que fazem parte do ambiente universitário sugerem a necessidade de propostas de ações preventivas e de promoção de saúde do trabalhador.

ABSTRACT Purpose To assess the risk of dysphonia and presence of voice change in professionals from different categories working in a university environment. Methods Cross-sectional research using the Dysphonia Risk Screening Protocol to analyze the variables sex, age, hydration, smoking, professional category and vocal demand and to calculate the final score. Voice recording took place in the work environment using the CAPE-V protocol. Judges performed the auditory-perceptual analysis. Data were compared between the groups with high/low risk of dysphonia and presence/absence of voice disorders. Results 80 individuals participated, with an average age of 47.7 years, 84% female. There was a high risk of dysphonia in 70%, and voice change in 34%. Insufficient hydration and smoking were frequent. In the group with a high risk of dysphonia and who had voice disorders, the presence of employees from the administrative area stood out, and, in the group with lower risk and no changes, health employees were outstanding. Older age was associated with voice disorders, regardless of groups. Conclusion Identification of high risk of dysphonia and the relevant presence of voice changes in individuals from different professional categories who are part of the university environment suggest the need to propose preventive actions and promote workers' health.

https://doi.org/10.1590/2317-6431-2020-2429 177 downloads

11.

Quality of life among total laryngectomized patients undergoing speech rehabilitation: correlation between several instruments
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Raquel, Ana Carolina Soares

; Buzaneli, Elaine Pires

; Silveira, Hevely Saray Lima

; Simões-Zenari, Marcia

; Kulcsar, Marco Aurélio Valmondes

; Kowalski, Luiz Paulo

; Nemr, Kátia

Clinics

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2020, Volume 75 elocation e2035

Abstract: En | Text: En | PDF: En

OBJECTIVE: The aim of this study was to correlate several instruments currently used for the assessment of the quality of life of patients who underwent total laryngectomy and speech rehabilitation. METHODS: A cross-sectional, observational study was conducted with 38 patients after total laryngectomy and speech therapy aiming to develop oesophageal speech. The patients were divided into the following two groups (19 participants each): speakers and non-speakers. The quality of life instruments used were as follows: visual analogue scale (VAS); Voice Handicap Index (VHI); Voice-Related Quality of Life (V-RQOL); Functional Assessment of Cancer Therapy - Head & Neck (FACT-H&N); European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30); European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck (EORTC QLQ-H&N35); and University of Washington Quality of Life (UW-QOL). RESULTS: The V-RQOL global health domain exhibited a strong correlation with the VHI. The EORTC QLQ-C30 exhibited a moderate to strong correlation with the EORTC QLQ-H&N35 functional domain in both groups. The EORTC QLQ-C30 functional domain exhibited a strong to moderate correlation with all other instruments in both groups. The UW-QOL exhibited a moderate to strong correlation with the VHI and EORTC QLQ-C30 in both groups. CONCLUSION: The EORTC QLQ-C30, EORTC QLQ-H&N35 and UW-QOL were the instruments that most correlated with the remaining instruments, indicating that any of the three can be used to assess the quality of life of the target population regardless of oesophageal voice development.

https://doi.org/10.6061/clinics/2020/e2035 187 downloads

12.

Cut-off point for high dysphonia risk in children based on the Child Dysphonia Risk Screening Protocol: preliminary findings
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Batista, Giovana Kaila Santos

; Simões-Zenari, Marcia

; Nemr, Kátia

Clinics

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2020, Volume 75 elocation e1682

Abstract: En | Text: En | PDF: En

OBJECTIVES: The objective of the study was to establish a cut-off point for high dysphonia risk in children using the Child Dysphonia Risk Screening Protocol (DRSP-C). METHODS: Through a preliminary study, voice recordings of 59 children (4-12 years of age) were collected during an auditory-perceptual analysis using the Consensus Auditory-Perceptual Evaluation of Voice protocol. Thirty of the patients had voice disorders (patient group), and 29 did not (control group). A risk score for dysphonia was then calculated, and data were compared between groups. The relationship between overall degrees of deviation and questionnaire scores was analysed. The questionnaire’s validity was verified from the area under the Receiver Operating Characteristic (ROC) curve, and cut-off points were obtained based on diagnostic criteria for screening procedures. RESULTS: The DRSP-C score was found to be higher for the patient group, as was the partial score for vocal behaviour. No correlation was found between overall degrees of dysphonia and questionnaire scores. The area under the ROC curve was measured as 0.678, denoting limited diagnostic capacity. The cut-off point was set at 16.50. Thus, above this value, dysphonia risk is higher. CONCLUSION: A cut-off point for high dysphonia risk was calculated. The DRSP-C proved to be a promising tool for children’s clinical vocal and health promotion and should be used in conjunction with General Dysphonia Risk Screening.

https://doi.org/10.6061/clinics/2020/e1682 182 downloads

13.

Comparison of fundamental frequency and formants frequency measurements in two speech tasks
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Viegas, Flávia

; Viegas, Danieli

; Guimarães, Glaucio Serra

; Souza, Margareth Maria Gomes de

; Luiz, Ronir Raggio

; Simões-Zenari, Marcia

; Nemr, Katia

Revista CEFAC

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2019, Volume 21 N. 6 elocation e12819

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: comparar as medidas de frequência fundamental (F0) e frequência dos dois primeiros formantes (F1 e F2) das sete vogais orais do português brasileiro em duas tarefas de fala em adultos sem distúrbios de voz e fala. Métodos: oitenta participantes entre 18-40 anos pareados por gênero foram selecionados após avaliações orofacial, ortodôntica e perceptivo-auditiva da voz e fala. Os sinais de fala foram obtidos de sentenças-veículo e vogais sustentadas e foram estimados os valores de F0 e frequências de F1 e F2. As diferenças foram verificadas por meio do teste t e foi calculado o Effect Size. Resultados: foram encontradas diferenças nas medidas de f0 entre as duas tarefas de fala em duas vogais no gênero masculino e em cinco vogais no gênero feminino. Nas frequências de F1 foram notadas diferenças em seis vogais nos homens e em duas nas mulheres. Nas frequências de F2 houve diferença em quatro vogais nos homens e em três nas mulheres. Conclusão: a partir das diferenças encontradas, conclui-se que a tarefa de fala para avaliação de frequência fundamental e frequências dos formantes no português brasileiro pode demonstrar resultados distintos tanto em medidas glóticas como supraglóticas na produção das diferentes vogais orais deste idioma. Desta forma, sugere-se que os clínicos e pesquisadores considerem ambas formas de emissão para interpretação mais apurada das implicações destes dados na avaliação da comunicação oral e no direcionamento de condutas terapêuticas.

ABSTRACT Purpose: to compare the measurements of fundamental frequency (F0) and frequency of the first two formants (F1 and F2) of the seven oral vowels of the Brazilian Portuguese in two speech tasks, in adults without voice and speech disorders. Methods: eighty participants in the age range 18 and 40 years, paired by gender, were selected after orofacial, orthodontic and auditory-perceptual assessments of voice and speech. The speech signals were obtained from carrier phrases and sustained vowels and the values of the F0 and frequencies of F1 and F2 were estimated. The differences were verified through the t Test, and the effect size was calculated. Results: differences were found in the F0 measurements between the two speech tasks, in two vowels in males, and in five vowels, in females. In the F1 frequencies, differences were noted in six vowels, in men, and in two, in women. In the F2 frequencies, there was a difference in four vowels, in men, and three, in women. Conclusion: based on the differences found, it is concluded that the speech task for evaluation of fundamental frequency and formants’ frequencies, in the Brazilian Portuguese, can show distinct results in both glottal and supraglottal measures in the production of different oral vowels of this language. Thus, it is suggested that clinicians and researchers consider both forms of emission for a more accurate interpretation of the implications of these data in the evaluation of oral communication and therapeutic conducts.

https://doi.org/10.1590/1982-0216/201921612819 2900 downloads

14.

Supracricoid Laryngectomy: The Function of the Remaining Arytenoid in Voice and Swallowing
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Buzaneli, Elaine Cristina Pires

; Zenari, Marcia Simões

; Kulcsar, Marco Aurélio Vamondes

; Dedivitis, Rogerio A.

; Cernea, Cláudio Roberto

; Nemr, Kátia

International Archives of Otorhinolaryngology

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jul 2018, Volume 22 N. 3 Pages 303 - 312

Abstract: En | Text: En | PDF: En

Abstract Introduction Supracricoid laryngectomy still has selected indications; there are few studies in the literature, and the case series are limited, a fact that stimulates the development of new studies to further elucidate the structural and functional aspects of the procedure. Objective To assess voice and deglutition parameters according to the number of preserved arytenoids. Methods Eleven patients who underwent subtotal laryngectomy with cricohyoidoepiglottopexy were evaluated by laryngeal nasofibroscopy, videofluoroscopy, and auditory-perceptual, acoustic, and voice pleasantness analyses, after resuming oral feeding. Results Functional abnormalities were detected in two out of the three patients who underwent arytenoidectomy, and in six patients from the remainder of the sample. Almost half of the sample presented silent laryngeal penetration and/or vallecular/ hypopharyngeal stasis on the videofluoroscopy. The mean voice analysis scores indicated moderate vocal deviation, roughness and breathiness; severe strain and loudness deviation; shorter maximum phonation time; the presence of noise; and high third and fourth formant values. The voices were rated as unpleasant. There was no difference in the number and functionality of the remaining arytenoids as prognostic factors for deglutition; however, in the qualitative analysis, favorable voice and deglutition outcomes were more common among patients who did not undergo arytenoidectomy and had normal functional conditions. Conclusion The number and functionality of the preserved arytenoidswere not found to be prognostic factors for favorable deglutition efficiency outcomes. However, the qualitative analysis showed that the preservation of both arytenoids and the absence of functional abnormalities were associated with more satisfactory voice and deglutition patterns.

https://doi.org/10.1055/s-0038-1625980 504 downloads

15.

Voice deviation, dysphonia risk screening and quality of life in individuals with various laryngeal diagnoses
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Nemr, Katia

; Cota, Ariane

; Tsuji, Domingos

; Simões-Zenari, Marcia

Clinics

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2018, Volume 73 elocation e174

Abstract: En | Text: En | PDF: En

OBJECTIVES: To characterize the voice quality of individuals with dysphonia and to investigate possible correlations between the degree of voice deviation (D) and scores on the Dysphonia Risk Screening Protocol-General (DRSP), the Voice-Related Quality of Life (V-RQOL) measure and the Voice Handicap Index, short version (VHI-10). METHODS: The sample included 200 individuals with dysphonia. Following laryngoscopy, the participants completed the DRSP, the V-RQOL measure, and the VHI-10; subsequently, voice samples were recorded for auditory-perceptual and acoustic analyses. The correlation between the score for each questionnaire and the overall degree of vocal deviation was analyzed, as was the correlation among the scores for the three questionnaires. RESULTS: Most of the participants (62%) were female, and the mean age of the sample was 49 years. The most common laryngeal diagnosis was organic dysphonia (79.5%). The mean D was 59.54, and the predominance of roughness had a mean of 54.74. All the participants exhibited at least one abnormal acoustic aspect. The mean questionnaire scores were DRSP, 44.7; V-RQOL, 57.1; and VHI-10, 16. An inverse correlation was found between the V-RQOL score and D; however, a positive correlation was found between both the VHI-10 and DRSP scores and D. CONCLUSION: A predominance of adult women, organic dysphonia, moderate voice deviation, high dysphonia risk, and low to moderate quality of life impact characterized our sample. There were correlations between the scores of each of the three questionnaires and the degree of voice deviation. It should be noted that the DRSP monitored the degree of dysphonia severity, which reinforces its applicability for patients with different laryngeal diagnoses.

https://doi.org/10.6061/clinics/2018/e174 1270 downloads

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